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81.
Hepatic adrenal rest tumor: Diagnostic pitfall and proposed algorithms to prevent misdiagnosis as lipid‐rich hepatocellular carcinoma
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Tomoko Sugiyama Takuma Tajiri Shinichiro Hiraiwa Chie Inomoto Hiroshi Kajiwara Seiichiro Kojima Kouske Tobita Naoya Nakamura 《Pathology international》2015,65(2):95-99
We present a case of adrenal rest tumor of the liver in which differential diagnosis from lipid rich‐hepatocellular carcinoma (HCC) was challenging. The patient was a 50‐year‐old woman in whom a 3‐cm tumorous mass was discovered in segment 7 of the liver during computed tomography evaluation of a uterine leiomyoma. The preoperative diagnosis was HCC, and subsegmental liver resection was performed. The tumor appeared as a well‐demarcated golden yellow nodule consisting of clear or partially eosinophilic cells arranged in a trabecular pattern. The initial impression of this lesion was that of clear cell type or lipid‐rich type HCC because it stained positive for Hep Par1, but negative for arginase‐1 and positive for CD56 which is one of the neuroendocrine markers. The lesion also stained positive for SF‐1 and 3β‐HSD, both of which are markers of adrenocortical tissue. The final diagnosis was hepatic adrenal rest tumor. Hepatic adrenal rest tumor should be considered in the differential diagnosis of segment 7 tumor. A diagnostic algorithm that includes immunohistochemical staining for CD56 and arginase‐1 is to rule out the possibility of lipid‐rich HCC. 相似文献
82.
Yutaka Ueda Tomotaka Sobue Akiko Morimoto Tomomi Egawa-Takata Chie Hashizume Hisayo Kishida Satomi Okamoto Kiyoshi Yoshino Masami Fujita Takayuki Enomoto Yoshimi Tomine Jun Fukuyoshi Tadashi Kimura 《Journal of epidemiology / Japan Epidemiological Association》2015,25(1):50-56
Background
Finding ways to improve the cervical cancer screening rates among young women has been seen as a critical national health problem in many countries, including Japan. The aim of the present study was to evaluate the effects of a free-coupon program for cervical cancer screening conducted by a local government under financial support from the Japanese national government.Methods
The personal cervical cancer screening information was analyzed for all female residents of Toyonaka City, including any past screening history and clinical results since the year 2009, when a free-coupon program for screening was started. These results were compared to results from 2008, prior to implementation of the free-coupon screening program.Results
The screening rates of women eligible for the free-coupon peaked dramatically compared to women of similar age who paid for their screening; however, the rates for the ineligible-age population also increased significantly in parallel to those in the free-coupon program, possibly by indirect peer and publicity effects. In women aged 20 to 25 years, the consecutive screening rate after a free-coupon screening was significantly lower than for those women who received a regular residential screening. After a free-coupon screening, the rate for participating in consecutive screenings depended significantly on the institution where the participant received her first screening test.Conclusions
These results suggest that, for a generation of young women 20–25 years of age, a free-coupon program for cervical cancer screening was effective in increasing the first-time participation rate for screening; however, the increase in first-time participation did not lead to the expected increase in consecutive screenings.Key words: cervical cancer screening, free-coupon, screening rate, consecutive screening 相似文献83.
Chie Kitazawa Shigeru Aoki Tsuneo Takahashi Fumiki Hirahara 《Clinical Case Reports》2015,3(12):997-999
Acute respiratory failure occurs in less than 0.1% of pregnancies. Thyroid storm should be included in the differential diagnosis of possible causes of acute respiratory failure occurring immediately after delivery, and delivery is a high risk factor for thyroid storm in pregnant women with thyrotoxicosis. 相似文献
84.
Bioactivation of loxoprofen to a pharmacologically active metabolite and its disposition kinetics in human skin
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Ryoko Sawamura Hidetaka Sakurai Naoya Wada Yumi Nishiya Tomoyo Honda Miho Kazui Atsushi Kurihara Akira Shinagawa Takashi Izumi 《Biopharmaceutics & drug disposition》2015,36(6):352-363
Loxoprofen (LX) is a prodrug‐type non‐steroidal anti‐inflammatory drug which is used not only as an oral drug but also as a transdermal formulation. As a pharmacologically active metabolite, the trans‐alcohol form of LX (trans‐OH form) is generated after oral administration to humans. The objectives of this study were to evaluate the generation of the trans‐OH form in human in vitro skin and to identify the predominant enzyme for its generation. In the permeation and metabolism study using human in vitro skin, both the permeation of LX and the formation of the trans‐OH form increased in a time‐ and dose‐dependent manner after the application of LX gel to the skin. In addition, the characteristics of permeation and metabolism of both LX and the trans‐OH form were examined by a mathematical pharmacokinetic model. The Km value was calculated to be 10.3 mm in the human in vitro skin. The predominant enzyme which generates the trans‐OH form in human whole skin was identified to be carbonyl reductase 1 (CBR1) by immunodepletion using the anti‐human CBR1 antibody. The results of the enzyme kinetic study using the recombinant human CBR1 protein demonstrated that the Km and Vmax values were 7.30 mm and 402 nmol/min/mg protein, respectively. In addition, it was found that no unknown metabolites were generated in the human in vitro skin. This is the first report in which LX is bioactivated to the trans‐OH form in human skin by CBR1. Copyright © 2015 John Wiley & Sons, Ltd. 相似文献
85.
Microvascular resistance in response to iodinated contrast media in normal and functionally impaired kidneys
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Osamu Kurihara Masamichi Takano Saori Uchiyama Isamu Fukuizumi Tetsuro Shimura Masato Matsushita Hidenori Komiyama Toru Inami Daisuke Murakami Ryo Munakata Takayoshi Ohba Noritake Hata Yoshihiko Seino Wataru Shimizu 《Clinical and experimental pharmacology & physiology》2015,42(12):1245-1250
Contrast‐induced nephropathy (CIN) is considered to result from intrarenal vasoconstriction, and occurs more frequently in impaired than in normal kidneys. It was hypothesized that iodinated contrast media would markedly change renal blood flow and vascular resistance in functionally impaired kidneys. Thirty‐six patients were enrolled (32 men; mean age, 75.3 ± 7.6 years) undergoing diagnostic coronary angiography and were divided into two groups based on the presence of chronic kidney disease (CKD), defined as an estimated glomerular filtration rate (eGFR) of < 60 mL/min per 1.73 m2 (CKD and non‐CKD groups, n = 18 in both). Average peak velocity (APV) and renal artery resistance index (RI) were measured by Doppler flow wire before and after administration of the iodinated contrast media. The APV and the RI were positively and inversely correlated with the eGFR at baseline, respectively (APV, R = 0.545, P = 0.001; RI, R = ?0.627, P < 0.001). Mean RI was significantly higher (P = 0.015) and APV was significantly lower (P = 0.026) in the CKD than in the non‐CKD group. Both APV (P < 0.001) and RI (P = 0.002) were significantly changed following contrast media administration in the non‐CKD group, but not in the CKD group (APV, P = 0.258; RI, P = 0.707). Although renal arterial resistance was higher in patients with CKD, it was not affected by contrast media administration, suggesting that patients with CKD could have an attenuated response to contrast media. 相似文献
86.
Tatsuya Shimizu Chie Saito Megumi Watanabe Ryota Ishii Tetsuya Kawamura Kei Nagai Akiko Fujita Shuzo Kaneko Hirayasu Kai Naoki Morito Joichi Usui Masahiro Yokosawa Yuya Kondo Sae Inoue Naoko Okiyama Kunihiro Yamagata 《Internal medicine (Tokyo, Japan)》2021,60(7):1101
A 40-year-old Japanese woman developed malignant-phase hypertension complicated by thrombotic microangiopathy, progressing to end-stage renal disease. Five years later, she was diagnosed with pulmonary arterial hypertension and interstitial pneumonia. Despite a lack of overt skin sclerosis, nucleolar staining in our indirect immunofluorescence analysis and nailfold capillaroscopy facilitated the diagnosis of anti-PM/Scl antibody-positive systemic sclerosis. We observed the persistent presence of anti-PM/Scl antibodies throughout the clinical course, suggesting that her kidney disease was scleroderma renal crisis. Anti-PM/Scl antibodies can be associated with multiple organ diseases. Careful attention to a patient''s antinuclear antibody pattern and dermatological findings may help clarify the etiology of undiagnosed diseases. 相似文献
87.
Kurihara Osamu Takano Masamichi Kakuta Tsunekazu Soeda Tsunenari Crea Filippo Adriaenssens Tom Nef Holger M. Boeder Niklas F. Yamamoto Erika Kim Hyung Oh Russo Michele McNulty Iris Araki Makoto Nakajima Akihiro Lee Hang Mizuno Kyoichi Jang Ik -Kyung 《Journal of thrombosis and thrombolysis》2021,51(4):1026-1035
Journal of Thrombosis and Thrombolysis - Antiplatelet agents and statin therapies are widely used in patients with known cardiovascular disease. Plaque rupture (PR) and plaque erosion (PE) are the... 相似文献
88.
89.
H Tanaka M Kurihara K Takahashi Y Honda M Asakawa S Oshima 《Kekkaku : [Tuberculosis]》1992,67(9):613-619
A 17-year-old man was admitted with a 5-month history of intermittent dyspnea on exertion, 10 kg weight loss, cough, sputa and fever. He did not smoke, had no apparent underlying pulmonary disease, and was not immunocompromised. Mycobacterium fortuitum was cultured from sputa at admission. Chest radiograph showed many thin-walled cavities and infiltration in the bilateral middle and upper fields. Chest CT detected multiple cystic lesions that were not revealed in conventional X-ray. It was suggested that the formation of the cystic lesions was one of the predisposing factor of Mycobacterium fortuitum pulmonary infection in this patient. The pneumonic change improved after six-month treatment using isoniazid, rifampicin and streptomycin, despite in vitro resistance of the bacilli to all of these drugs. 相似文献
90.